Minutes
Ch.atham County Board of Health Tuesday, January 23, 2007
The Chatham County Board of Health (BOH) met in official session on Tuesday, January 23,2007 at the Pittsboro Presbyterian Church. Nine members attended the meeting.
Present
Bill Browder, Chair Danny Wimberly
Patrick Barnes, Commissioner James Kurz, M.D.
Van S. Romine, O.D.
Linda Brewer Ellington, R.N.
Gregory King, P.E.
Timothy Scheetz, D.D.S Kevin Monee. D.V.M Absent
Jane Miller Mary Jackson
Welcome and Call to Order
Staff
Holly Coleman Vanessa Jeffries Mary Linker Shirley Cotten Vicky Epps Andy Siegner Carla Strickland Marissa Jelks Michael Yarborough Denise Estridge Gary Thomas
Public
Joe Pardington
Chair Browder called the meeting to order and welcomed everyone.
Introduction of New Staff
There were no new staff to be introduced.
Consent Agenda
The consent agenda contained the 11/28/2006 minutes, the proposed 1/23/2007 agenda, acceptance of$5,l01.00Men as Navigators Health Initiative, acceptance of$7,575.00 Women's and Children's Immunization Branch and Continuation Grant Applications.
Chair Browder asked for a motion to approve the consent agynda and the 11/28/2006 minutes. The consent agenda was approved on the motion of Danny Wimberly and seconded by Van S. Romine. The vote was unanimous.
Announcements
Interim Director Coleman wished everyone.a Happy Nevv Year. The renovations of the Dunlap Building will begin on February 5. E11lployees ary in the process of moving into temporary offices.
A site visit was conducted earlier in January by Blue Cross Blue Shield for the purpose of accrediting the Health Department. The Health Department received less than a week's notice of the impending site visit. The site visitor was complimentary during the visit.
Notification of accreditation is pending. Interim Director Coleman commended the efforts of Vicky Epps, Cathy Wright and the rest of the clinical staff in pulling everything together for the site visit.
Public Health Highlights
a. Community Health Assessment
Marissa Jelks, Social Research Associate, presented the results of the 2006 Community Health Assessment. Theprocess of completing the 2006 Community Health Assessment actually began about a year and a half ago with the help of many different
county/community organizations and agencies. The Community Health Assessment is required every 4 years and is used to help identify major health issues in Chatham County. The data gathered for the Health Assessment actually comes from many different sources throughout the county: interviews conducted with Chatham County community members and providers, community forums held in Pittsboro and Siler City, focus groups, community opinion surveys that were distributed throughout the county and also available online, youth risk behavior surveys that were given out to middle and high schools throughout the county from these different sources a list of health priorities was developed. The assessment results are not considered to be statistically significant due to ce11aindata limitations, including: participant bias during interviews and focus groups, response bias with the community opinion surveys and African Americans and women were overrepresented in the survey population.
Chatham County Population Data: according to the NC State Data Center the
estimated population in Chatham County in 2005 was 58,002; by 2010 the population is expected to grow 24.9% to 61,635. In 2005, the 65 and older age group was 14.8% of the population and the 20-34 year old age group was 18.8% of the population. Between 1990 and 2000, the North Carolina census of Hispanic/Latino populations recorded a 613.1 % increase in Chatham County.
Chatham County Housing Data: in 2000, the median household price for Chatham County homes was $127,000 compared to the State's $108,300. In 2000, 11% of the homes in Chatham were valued at $300,000 or more compared to the state average of 5.6%. In 2000, 1.1% of Chatham County residents did not have complete plumbing facilities compared to 0.6% of North Carolinians as a whole.
Chatham County Economic Data: The unemployment rate in Chatham County has consistently decreased each year from 5.1% in 2002 to 3.8% in 2005. Ofthe top 10 employers in Chatham County,S are manufacturing companies (Towns ends Inc., Gold Kist Inc., Performance Fibers Inc., Joan Fabrics Corp and Moncure Plywood Inc).
Chatham County Income Data: In 1999, the median household income for Chatham County was $42,851 which was $3,667 higher than the NC average. In 2000, 22% of households made $75,000 or more compared to 18.3% ofNC households. In 2000, 7.1%
of families] ived below the poverty line. In 2000, households run by women with
2
children under 18 lived in poverty 36.2% of the time and household run by women with children under 5 Jived in poverty 51.5% of the time.
Miscellaneous
iD Due to the size of Chatham County, transportation is a big issue for many residents.
~ Chatham County's crime rate is the lowest of all surrounding counties and has been the lowest since the state started keeping statewide statistics in
1996.
~ The top ten causes of death in Chatham Countyare:l)Heart Disease, 2)Cancer, 3)Stroke, 4)Chronic Lower Respiratory Disease,
5)Unintentional Motor Vehicle Injuries, 6)Diabetes, 7)All Other
Unintentional Injuries, 8)Pneumonia and Influenza, 9)Alzheimer's Disease and 1O)Kidney Diseases. Six of the ten leading causes of death in
Chatham are from chronic diseases. Minorities have a higher risk than whites of dying from 7 of the top 10 causes of death (Heart Disease, Cancer, Stroke, Diabetes, Alzheimer's Disease and Unintentional Motor Vehicle Deaths). Men have a higher risk than women of dying from 5 of the leading causes of death (Heart Disease, Influenza/Pneumonia,
Unintentional MotorVehicle Deaths and All Other Unintentional Injuries).
The Youth Risk Behavior Survey was taken by 2625 students in grades 7-12.
9 Middle School Nutrition Results: 76.3% of students ate French fries at least once within the last 7 days; 93.8% drink at least one or more sweetened beverages in a typical day; and 42.6% of students bought food from a vending machine within the last 7 days.
@ High School Nutrition Results: 86.3% of students ate French fries at least once within the last 7 days; 90.9% drink at least one
sweetel1ed beverage in a typical day; and 60.9% of students bought
Fr" ..•rI f';r"""'"'" ''''''Ddl'ng mn;',1-.;~" n·;+1-.1·- +he1~~+ "7 ...!~_.~
iVV\..L-L VLU U v\..< 1 " 11a\..tl1111C VVll.llll L la~l I UdY~~
Middle School Physical Activity Results: 86.7% are active on typical school days and 82.9% are active on typical weekend days;
39.6% watch 3 or more hours of TV per day on a typical school day and 57.4% watch 3 at more hours a day on weekend days; and 97.8%
have PE class at least once a week.
High School Physical Activity Results: 65.5% are active on typical schooldays and 74.3% are active on typical weekend days; and 40.4% have PE at least once a week.
Middle School Injury and Violence Results: 11.1% never or rarely wear a seatbelt while riding.in a car; 56.7% never or rarely wear a helmet when ridingabike; 7.1%.did not go to school for one or more days in the P~st 30 because they didn't feel safe; and 13.8% have
on the past 30 because they didn't feel safe; and 13% have thought seriously about killing themselves.
The 2006 Top Priorities in Chatham Cou.nty are:
1) Jobs/Adequate Employment, 2) Alcohol/Other Drug Use, 3) Overcrowded Schools
&Lack of Affordable Health Insurance, 4) Population Growth & Obesity, 5) Affordable
Housing & Water Quality, 6) Crime, 7) Unsafe SexlUnintended Pregnancy, 8) Family Violence, 9) Affordable Health Care, 10) Recreation &Affordable and Available Child Care, 11) Diabetes.
The 2006 Health Priorities are: 1) Alcohol and Other Drug Use, 2) Lack of
Affordable Health Insurance, 3) Obesity, 4) Water Quality, 5) Unsafe SexlUnintended Pregnancy, 6) Family Violence, 7) Affordable Health Care, 8) Recreation and 9) Diabetes.
The next step in this process will be to contact members of Healthy Chatham and start analyzing 2 or 3 of these priorities at a time to develop action plans for each.
Chair Browder thanked Marissa for the presentation. Interim Director Coleman
commended everyone involved in working on the 2006 Community Health Assessment for all of their hard work. Chair Browder noted how important the Community Health Assessment is and how it directly has an impact on Health Department services.
b. Commu.nity Health Priorities
Chair Browder led a discussion to gain input on the assessment from members. Dr. Kurz commented on the issue of obesity in schools and the fact that some schools outside Chatham have eliminated the availability of soft drinks during the school day. Chair Browder added that some schools have even taken the fryers out of the cafeterias. Dr.
Kurz also inquired as to how the school systems are dealing with soft drink machines and how difficult it would be to get rid of them all together. Marissa stated that the revenue made from soft drink machines go toward funding recreational activities for youth and that it would be highly unlikely that the schools would eliminate them totally but perhaps could add milk, water or 100% fruit juices to these machines so that kids would have healthier choices. Dr. Kurz also commented on the percentage of youth that eat French fries at school. Unfortunately, some students consider French fries to be the only edible food offered in school cafeterias. Mary Linker added that most school cafeterias are self- supporting and want to have foods that kids will buy. Dr. Kurz suggested that schools could start implementing healthier behaviors by eliminating beverages that are high in sugar and calories. Shirley Cotten mentioned that there had been an initiative to
eliminate soft drinks in elementary and middle schools but she was not sure how that has progressed. Dr. Kurz stated that the biggest problem with obesity seems to be centered on middle school-aged children and that would be a good place to start implementing healthier behaviors. Dr Sheetz mentioned the high number of young patients he sees with dental caries in his practice and related this to drinking sugared drinks. Shirley Cotten also mentioned that not only do kids need to practice healthier eating habits but they also need to increase their physical activity.
4
Linda Ellington asked that after Healthy Chatham has developed an action plan how do the changes actually take place and who is responsible. Marissa stated that Healthy Chatham reports to Healthy Carolinians at the state level. The Health Department works with other coalitions on these issues/priorities. This process is on going.
Chair Browd~r asked Marissa if there were any surprises that she discovered while doing the Health Assessment. She thought that the housing data on Chatham County uncovered a couple of surprises, one being that in 2000, 11% of the homes in Chatham were
$300,000 or more while 1.1% of Chatham residents did not have complete plumbing facilities.
Dr. Kurz also added that the perception in high school seems to be that marijuana is a safe drug. There seems to be an increasing acceptance of marijuana use and this is definitely not a safe drug. He also stated that substance abuse seems to be the number one problem in Orange and Durham Counties and is increasingly becoming a rural
community problem.
Chair Browder inquired about the Lack of Affordable Health Insurance being #2 on the 2006 Health Priorities List and how big of a problem this really is. Marissa stated that there was no specific data on the problem but based on national statistics it seems that each year the number of people without health insurance increases.
Administrative Reports
Denise Estridge reviewed the Expenditure and Revenue Report through December 2006 during the budget update. The department is at 50% of the Fiscal Year, total
expenditures through December are at 50%. The total Revenue for this period is at 47%
and Local Appropriation is at 52%.
Denise updated the Board on personnel matters. For the period of November 14 through·
January 12, 2006 the Health Department had 3 new hires: 1 Public Health Educator effective November 27, 1 Licensed Practical Nurse effective December 4 and 1 Interpreter effective December 4.
The Health Department is currently advertising for the following positions:
•• Health Director
aD 1 Public Health Nurse (Preventive Health Services Division)
CD 1 Public Health Educator II (Community Health Promotion and Advocacy) There have been two resignations: 1 Health Educator II and 1 Public Health Nurse II.
New Business
a. Policy Review and Adoption
On the Fee Policy, Dr. Romine had a question about page 6 at the bottom-numbers 18,
been the policy of the county to use collection agencies to collect bad debts but if a patient comes back into the Health Department his/her debt is reactivated. The Health Department also uses the NC Debt Set-Off Program to collect delinquent debts. Chair Browder asked for a motion to approve the Fee Policy with the recommended changes.
Danny Wimberly made the motion and it was seconded by Commissioner Barnes. The vote was unanimous.
The Board reviewed the Orientation Policy. The only changes made to this policy were forn1at changes. There were no changes made to the policy itself Danny Wimberly made a motion to approve the Orientation Policy and it was seconded by Dr. Monee. The vote was unanimous.
The Board reviewed the Policy Review Policy. Again, the only changes made to this policy were format changes. There were no changes made to the policy itself Dr.
Romine made a motion to approve the Policy Review Policy and it was seconded by Danny Wimberly. The vote was unanimous.
b. Accreditation Team Appointment
Sometime between January and MaTch 2008, the Health Department will have a site visit for the purpose of reaccreditation. The Health Department staff will need to start getting ready for this process. The Management Team is requesting the Board to appoint a Board member to serve on the Accreditation Team. Chair Browder asked if any BOaTd member would be willing to serve on the Team. Linda Brewer Ellington volunteered to represent the Board of Health on the Accreditation Team.
Other Business
3. Health Director Search
The Health Director position has been readvertised. January 31 is the cut off date for all applications. The Board members on the previous Health Director Search Committee were: Mary Jackson, Patrick Barnes, Kevin Monce and Bill Browder. Danny Wimberly was the Chair of the Committee but now that he is leaving he must be replaced. Van Romine will Chair the Health Director Search Committee. Carolyn Miller had served on the Committee previously and the Committee felt she was a tremendous asset and would like for her to continue to serve. Carolyn is scheduled to be on medical leave in
February. Chair Browder suggested that the Committee wait until Carolyn returns before beginning the screening process. Interim Director Coleman will keep the Board apprised of Carolyn Miller's return. Van Romine had a question as to whether or not minutes were kept on the Committee meetings. Danny Wimberly stated that Carolyn Miller kept all of the minutes and notes from the meetings. Danny Wimberly made a suggestion that the Committee cut down on the number of questions that they ask the candidates.
b. Recognition of Danny Wimberly
The Board recognized Danny Wimberly for his 8 years of service on the Board of Health.
Chair Browder stated that he has seen a lot of fellow Board members as he visited various BOaTdsof Health across North Carolina, but no one with more practical wisdom,
commitment and willingness to say what needs to be said at Board Meetings than Danny.
The Board will miss him tremendously. Chair Browder thanked Danny for all of his
6
years of service and presented him with a plaque and Chatham County afghan. Danny stated that he has enjoyed working with everyone and appreciates the staff and everything that they have done for the Board of Health. Danny thanked everyone again. Those present recognized Mr. Wimberly's service with a round of applause.
Adjournment
Kevin Monee moved for adjournment and Commissioner Patrick Barnes seconded the motion. The vote was unanimous and the motion carried.
Board of Health Chair, Bill Browder
gmt
Secretary Ex-Officio, Holly Coleman
